IndividualActive
Jeremy Shupperd, CPO
NPI 1306698071 · Prosthetist · Boise, ID
Provider details
- NPI number
- 1306698071
- Entity type
- Individual
- Primary specialty
- ProsthetistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- CPO
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Orthotist222Z00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
427 N Curtis Rd
Boise, ID 83706-1439
Phone: (208) 342-4104
Fax: (208) 342-4106
Approximate (ZIP-level) locationGet directions
Mailing address
427 N Curtis Rd
Boise, ID 83706-1439
Additional practice locations (2)
- 504 N 10th Ave Ste aCaldwell, ID 83605-2925Phone: (208) 453-6404Fax: (208) 453-6402
- 542 Addison Ave WTwin Falls, ID 83301-5039Phone: (208) 342-4104Fax: (208) 736-7332
Registry dates
- Enumerated
- 2024-04-04
- Last updated
- 2024-04-04
- Certified
- 2024-04-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.